Health and Accident Insurance

An employer is issued a group medical insurance policy. This single contract is known as a(n) entire contract master policy certificate of coverage employer contract

What is issued to each employee of an employer health plan? Provision Receipt Policy Certificate

Which of the following decisions would a Health Savings Account (HSA) owner NOT be able to make? The amount contributed by the employer The amount contributed by the owner The underlying account investments used The medical expenses paid for by the HSA

Which of the following is INELIGIBLE to participate in a Section 125 Plan? Key Employee in a C-Corp Highly Compensated Employee in an S-Corp A C-Corp Owner with a greater than 2% share An S-Corp Owner with a greater than 2% share

Under the subrogation clause, legal action can be taken by the insurer against the responsible third party beneficiary policyowner State

According to HIPAA, when an insured individual leaves an employer and immediately begins working for a new company that offers group health insurance, the individual is eligible for coverage upon hire must wait 360 days to be eligible for coverage must continue coverage with the previous employer is eligible for only health insurance, not life or dental insurance

Justin is receiving disability income benefits from a group policy paid for by his employer. How are these benefits treated for tax purposes? Partially taxable income Non-taxable income Taxable income Conditionally taxable income

When are group disability benefits considered to be tax-free to the insured? When the recipient pays the premiums When the employer pays the premiums When both the employer and recipient pay the premiums When benefits paid are equal to or lower than the recipient's salary

Which type of business insurance is meant to cover the costs of continuing to do business while the owner is disabled? Disability overhead policy Business continuation policy Disability buy-sell policy Business overhead expense policy

Sole proprietors are permitted tax deductions for health costs paid from their earnings in the amount of costs that exceed 7 1/2 % of AGI costs that exceed 10% of AGI 100% of costs no deduction permitted

In an employer-sponsored contributory group Disability Income plan, the employer pays 60% of the premium and each employee pays 40% of the premium. Any income benefits paid are taxed to the employee at Employee has no tax liability 40% of the benefit 60% of the benefit 100% of benefit

Under a disability income policy, which provision would be payable if the cause of an injury is unexpected and accidental? Presumptive disability provision Absolute accidental provision Accidental death benefit provision Accidental bodily injury provision

The election of COBRA for continuation of health coverage will increase the coverage and lower premium maintain the same coverage and increase premium increase out-of-pocket costs and lower premium decrease out-of-pocket costs and maintain same premium

Ron has a new employer and wishes to enroll in the company's group health plan. In determining whether his pre-existing health condition applies, Ron cannot have more than a ___ day gap without previous health insurance. 45 63 75 90

Susan is insured through her Group Health Insurance plan and changed her coverage to an individual plan with the same insurer after her employment was terminated. This change is called a(n) crossover conversion exchange extension of benefits

Health insurance involves two perils, accident and ____. death sickness disability liability

An insurer has the right to recover payment made to the insured from the negligent party. These rights are called contributory indemnity estoppel subrogation

Without a Section 125 Plan in place, what would happen to an employee's payroll contribution to an HSA? It would be considered taxable income to the employee The employee would not be allowed to an HSA The employer would pay payroll tax and FICA on the contribution amount The employer would not be allowed to deduct the contribution from the employee's pay

Under the Health Insurance Portability and Accountability Act (HIPAA), the employee's new Group Health Plan will verify Creditable Coverage so that the employee's benefits still owed can be claimed employee cannot be excluded from the new employer's health plan employee's waiting period for coverage of a preexisting condition can be reduced under the new employer's health plan new health insurance carrier will have a clear record of any chronic conditions that exist

A group Disability Income plan that pays tax-free benefits to covered employees is considered non-contributory partially contributory group contributory fully contributory

Which of the following would evidence ownership in a participating health insurance contract? Stock ownership Irrevocable beneficiary status Policy ownership Collateral assignment

Which of the following does Coordination of Benefits allow? Allows the secondary payor to reduce their benefit payments so no more than 100% of the claim is paid Allows both a group health plan and individual health plan to coordinate their benefit payments Allows the deductible to be spread out between all the health providers Allows each health provider to pay 100% of the claim

Credit Accident and Health plans are designed to permit creditors the ability to require that coverage be purchased through insurers of their choice provide permanent protection help pay off existing loans during periods of disability not permit free choice of coverage selection

Mark continues working after the age of 65 and is covered through his employer's group health plan. Which of the following statements is TRUE? He's not eligible for Medicare His group health plan and Medicare pay 50/50 Medicare is the secondary payer Medicare is the primary payer

Coordination of Benefits regulation applies to all of the following plans EXCEPT Group vision plan Preferred Provider Organization plan Self-funded group health plan Group health plan